In-Home Medical Services…Improving Lives While Lowering Cost

With A Rapidly Growing Elderly Population, Will Trends Ever Reverse To Meet Demands?

By 2030, the number of Americans age 65 and older will account for 20 percent of the U.S. population, the nation’s elderly population is expected to double to 72 million — or roughly the current population of Arizona, California, and Florida combined. Two-thirds of the people in this age group have multiple chronic conditions and likely would need regular health care visits, which they may have difficulty accessing. For generations, the “home visit” was an institution, something a doctor, black bag in hand, just did.

In 1930, house calls made up about 40 percent of physician encounters with patients in the United States, according to a recent article in the journal Clinics in Geriatric Medicine.By 1950, that number had dropped to 10 percent. And by 1980, home visits accounted for a mere 1 percent.

House Call Medical Services For Medicare Patients

In 1998, Medicare modified its billing procedures, making it easier for practitioners to receive payment for home visits to the elderly and chronically ill and increasing payments by 50 percent. Since then, Medicare statistics show a large bump in physician house calls, from 2.2 million in 2007 to almost 4.2 million in 2013. Although house calls still account for less than 1 percent of all outpatient visits, “there is certainly a rapid growing demand,” says Constance Row, executive director of the American Academy of Home Care Physicians. Row backs efforts to increase the use of house calls as a “win-win situation for everyone. It is one of those things that patients want, that their families and caregivers want and also something that would actually improve medical outcomes and save money.”

She can maneuver around her small home in a motorized scooter she controls with a joystick, but going much beyond that is onerous and “just wears me out . . . getting my clothes on and whatnot . . . everything,”

For Mary Kay Franklin, 71, having a doctor who performs house calls has been a blessing. An Arizona native, she suffers from several chronic conditions, including multiple sclerosis, which makes it hard for her to move around, let alone leave her home in East Mesa to see doctors. She can maneuver around her small home in a motorized scooter she controls with a joystick, but going much beyond that is onerous and “just wears me out . . . getting my clothes on and whatnot . . . everything,” she says. she seems delighted when Dr. Talluri, MD, of Cholla Medical Group-Concierge In-Home Medical Service program, shows up on a recent afternoon. His visits, she says, “they are a blessing…. . it really is a blessing.”

Indeed, it is patients like Franklin: elderly, with multiple conditions and limited mobility-who represent the biggest Medicare clientele for house calls.

They are what Constance Row, calls the “home-limited elderly,” people who don’t see a doctor routinely because getting out is so difficult. This “forgotten population,” Row says, is “getting much lower-quality care than they should have.” When something goes wrong, they end up in emergency rooms or hospitalized, being treated in a crisis rather than routinely with an eye toward prevention.

According to Row, studies have suggested that In-Home Care may keep people in their homes longer and reduce mortality, particularly in the frail elderly population. That is probably partly due to physicians’ being able to identify new or worsening medical problems that, left untreated, could contribute to further disability and even death.

Saving Money While Improving The Quality Of Medical Care For Home-Bound Patients:

Although homebound patients represent only 5 percent of the Medicare population, they consume more than 43 percent of the budget, according to a congressional analysis. An ER visit can be more than 10 times the cost of a typical house call, which Row pegs at $100 to $150.

Or as Dr. Talluri puts it, by doing house call medical care he is not only given the opportunity to be a good doctor, but he also gets to play the part of “counselor, social worker, advocate and, in some cases, ‘family.’ I give a lot – but get much more in return.”“We’re just seeing the tip of the iceberg of this, with the focus on chronic care management and chronic illness, with more and more Assisted Living Facilities, Group Homes, and Retirement Communities,” Talluri says. “If we ACT rather than REACT to keep patients out of hospitals and emergency rooms, they do better, have better clinical outcomes, and at the end of the day, improves their way of life.”

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[…] remotely, in a patient’s home rather than traditionally in a hospital or a doctor’s office. A medical practice that provides many benefits for doctors, patients, families, insurance companies and assisted living homes. Commonly referred […]